If heavy foods like cheeseburgers, burritos and ice cream trigger acid reflux, your stomach acid is probably too weak. Most acid reflux is triggered by insufficient acid production, not excess. When stomach acids are too weak, indigestion ensues and food stagnates. Food that sits too long in the stomach tends to regurgitate. Antacids actually eat up the little acid that remains, making the problem worse. If your doctor recommended antacids, demand an acid test of your stomach.
Origins & Introduction
Your stomach produces approximately 2 liters of acid per day. Stomach acid functions to kill bacteria in the food we have eaten, increase absorption of dietary calcium and iron, and activate pepsinogen, an enzyme responsible for breaking down proteins. Acid production is stimulated by release of gastrin, a hormone secreted in the stomach in response to vagus nerve excitation, stomach distension, partially digested proteins and amino acids in the stomach, and hypercalcemia.
After swallowing, food passes from the throat to the stomach through the esophagus. Once in the stomach, a ring of muscle fibers called the lower esophageal sphincter (LES) prevents food from traveling backwards up into the esophagus. Sometimes, however, the acidic contents of the stomach are regurgitated or leak backup through the valve into the esophagus, a condition called acid reflux. Metaphorically, the stomach functions to accept and absorb food, and it is supposed to move food downward. Acid reflux is a sign that the stomach is unable to perform these functions. There are several patterns of imbalance that must be carefully differentiated before selecting an appropriate line of treatment.
Acid reflux is extremely common. 20% of adults experience weekly heartburn. It is also common in infants and children, due to an immature digestive tract, but may be overlooked by doctors. Acid reflux in infants usually resolves by their first birthday.
According to Ayurveda, indigestion places a significant role in the development of acid reflux. It is called amla pitta because the indigestion eventually results in aggravated pitta (specifically pachaka pitta) even though pitta is usually not the underlying cause. Pitta often gets blamed but the stomach is the home of Kapha, and Kapha indigestion from low metabolism and mucus obstruction are common patterns leading to acid reflux. There are several other main contributing factors to the development of acid reflux including gastritis, hypoacidity, hyperacidity, stress, bile reflux, pharmaceuticals, and other physiological changes. Treatment should address these root causes, repair digestion, redirect food downwards, and reduce inflammation.
GERD is the disease resulting from chronic acid reflux. Acid reflux may irritate the esophagus causing heartburn or chest pain, burn the vocal chords causing hoarseness. Rarely, acid reflux enters the lungs and may cause pneumonia and bronchospasm. Chronic acid reflux may lead to inflammation of the esophagus, stricture or narrowing of the esophagus due to scarring from the inflammation, an esophageal ulcer, and Barrets Esophagus, a pre-cancerous condition characterized by abnormal changes to cells lining the esophagus. Chronic acid reflux may also erode the protective enamel on teeth.
Development & Types
Acid Reflux, Indigestion & Food Stagnation
When the stomach is overwhelmed, indigestion ensues and food stagnates. This is why the most common type of acid reflux arises from heavy Kapha provoking foods such as cheeseburgers, burritos, ice cream and fried foods. Food stagnates because digestive organs are programmed to hold back food until properly digested. Normally, when one stage of digestion is complete, peristalsis (regular wavelike muscular contractions of the intestines) propels the food further down the digestive tract. When indigestion delays food movement, bacteria feed on the partially undigested food and multiply.
Food becomes rotten, foul smelling and gaseous as it lays stagnant in the intestine. Stagnation in the stomach, a condition known as gastroparesis, causes a subjective feeling of heaviness, burping, upper GI (short for gastro-intestinal) distension and regurgitation of food mixed with acid. Rotten food also contains chemicals released by bacteria that may increase inflammation and degradation of tissue (gastritis). Indigestion may involve one or more doshas.
Kapha type indigestion is characterized by low metabolism and mucus obstruction. Low metabolism, perhaps due to hypothyroid, makes the digestive tract cold and sluggish, and contractions of stomach muscles weak. Mucus buildup in the stomach from a diet high in sweets, dairy, wheat, red meat, and refined sugars directly obstructs the action of digestive acids. Common symptoms of Kapha type acid reflux include a subjective feeling of heaviness, acid reflux that appears after late-night meals, morning mucus and congestion in the respiratory tract, as well as a thick coating on the tongue and a tendency to gain weight.
Gastritis is inflammation of the digestive tract. Gastritis ultimately leads to impairment of digestive function, a Vata disorder. Infection, auto-immune disorders, loss of the protective mucus barrier, bile reflux and other pathological agents can cause gastritis. When inflamed, the folds in the stomach become enlarged and swollen. Common signs of gastritis include abdominal tenderness and teeth marks on the tongue border. One type of gastritis that causes acid reflux is chronic atrophic gastritis. Atrophic refers to 'atrophy, a medical term meaning loss of function. In atrophic gastritis, there is a loss of acid secreting cells of the stomach. The inability to secrete a normal quantity of acids is a condition known as hypochlorhydria or hypoacidity.
Infection with H. pylori, a gram negative bacteria, is a common cause of acute gastritis which may become chronic and atrophic. The organism is predominantly found beneath the gastric mucosal layer that lines the surface epithelium of the stomach. H. pylori produces abundant quantities of urease, an enzyme that functions to produce ammonia in order to neutralize gastric acid. Urease also inflames the gut wall. An interesting side note: although gastritis secondary to H. pylori infection may cause acid reflux, the neutralization of stomach acids by urease actually reduces symptoms of GERD including esophageal irritation.
The stomach is normally well protected by a thick layer of mucus. Dehydration may leave stomach glands unable to produce enough mucus. Alcohol, smoking, and spices, carbonic acid (in carbonated beverages) and hyperacidity can also erode the protective mucus barrier of the stomach, and then irritate the tissues beneath causing gastritis.
Digestion and the Blood
Most of the energy and fluids used for digestion are supplied through the blood. Thus, digestion is only as strong as the blood and circulation. A high-Vata lifestyle including overexertion and skipping meals deplete the blood. Stress effectively shuts down circulation to digestive organs. Cold temperature also constricts blood vessels and circulation. Anemia and other blood deficiencies can also cause cold temperature related circulation problems. Deficiency-related cold is associated with feeling cold often even during the summer, voiding a larger quantity of soft but formed stools, and clear, thin nasal discharge.
Dehydration reduces the production of digestive juices by the stomach, liver and pancreatic glands creating a condition of "Dry Stomach Syndrome". Consider that 2 liters of acid production a day could easily drain the blood of much needed fluids, especially in thin Vata individuals. Here are some signs of a dry stomach:
If the tongue is dry, chances are the stomach is too.
Dry skin is an indicator that all glands are dry, including stomach, liver, and pancreas.
A small appetite could indicate insufficient acid production in the stomach.
Bloating, gas and burping signify food remains partially undigested
The blood, circulatory and gastritis based deficiencies discussed above reduce acid production, a condition called hypoacidity. Hypoacidity generally causes Vata-type indigestion, characterized by frequent hunger but a feeling of fullness or heaviness after a small meal, which may be followed by upper abdominal distention, bloating and burping. Hypoacidity related indigestion is a common, if not the leading, cause of acid reflux and should be ruled out before taking antacids.
Although most western medical doctors assume hyperacidity in all cases of acid reflux, we believe hyperacidity may be the exception, not the rule, in cases of acid reflux. Hyperacidity is fundamentally associated with aggravated Pitta. It results when the blood (bhrajaka pitta) and the stomach (pachaka pitta) are overactive, making a person 'hot blooded' both emotionally and physically. Typically, symptoms appear 1-2 hrs after eating. Vasodilation, thinning of the blood and increased cardiac output together increase the rate of digestion and can cause hyperacidity. Smoking, alcohol, and excess use of sour and spicy foods are just some of the ways to over-stimulate digestive juices.
Stress, worry, anger and frustration also increase production of stomach acids (Vata pushing Pitta). Emotional stress stimulates the vagus nerve, in turn stimulating secretion of gastrin and production of stomach acids. Gastrin also relaxes the lower esophageal sphincter (LES), leaving the esophagus vulnerable to acid reflux. Via the sympathetic nervous system, stress causes blood vessels to constrict, decreasing production and quality of mucus. In addition to directly causing acid reflux, more acid and less mucus leaves the stomach vulnerable to "stress gastritis".
Whereas heaviness and low appetite are commonly associated with hypoacidity, a person with chronic hyperacidity would likely have a large appetite and feel hungry between meals. The tongue will generally have a red tip or show other heat signs including a rapid, strong and bounding pulse. Hyperacidity will show fewer signs of indigestion-related gas and bloating.
Acid Reflux and Bile Reflux
Acid reflux must be differentiated from bile reflux. Bile reflux has similar symptoms to acid reflux. Bile is an alkaline salt produced by the liver and is normally released by the gallbladder into the small intestine. Then bile emulsifies fats for absorption into the lymphatic system. Sometimes, bile backs up through the pyloric valve into the stomach causing atrophic gastritis eventually leading to acid reflux.
Bile reflux may result from bile insufficiency (Vata in ranjaka pitta), gallbladder stasis (Kapha blocking ranjaka pitta), or a defective pyloric valve, and any kind of food stagnation in the duodenum. The duodenum is the section of the small intestine just after the stomach. Food stagnation in the duodenum signals the stomach to stop releasing food, causing backup and acid reflux.
Insufficient bile impairs digestion of fatty foods causing stagnation. If related to Vata deficiency, symptoms will include yellow, light colored stools, emotional instability, and hypogylcemia. Common signs of Pitta related bile obstruction are yellowing of the eyes, nails, or skin, secondary to liver distress and inflammation. Gall bladder stasis from Kapha occurs when thick bile gets stuck in the gallbladder leading to indigestion, irritability, red puffy cheeks or hands, and tiredness after eating fatty foods such as french fries or potato chips.
Antacids reduce symptoms and irritation from acute acid regurgitation but they do not address the root cause. Antacids are often prescribed before determining whether the underlying cause is hyper or hypo-acidity. Antacids actually increase food stagnation and exacerbate chronic acid reflux in hypo-acidic clients. The following western pharmaceuticals can increase the risk of acid reflux:
Non steroidal anti-inflammatory drugs (NSAIDS) including aspirin
Hiatal hernia (a condition where a portion of the stomach protrudes upward into the chest), injury to the lower esophageal sphincter (LES), inflammation, and overeating can cause stomach contents to leak into the esophagus. Full or partial intestinal obstruction by compacted or otherwise stagnant fecal matter can cause backup. Increased pressure on abdominal organs during pregnancy can cause late term acid reflux. Strenuous exercise such as weight lifting increase the risk of acid reflux. Hiccup, retching, spasms, and vomiting cause the reverse flow and regurgitation of stomach contents.
Treatment of acid reflux should repair digestion, redirect food downwards, reduce inflammation, and address the root cause, as indicated above.
Carbonated beverages - accumulation of gaseous carbon dioxide causes burping and acid to bubble upwards. In addition, carbon dioxide in aqueous solution forms carbonic acid, further eroding the mucus lining of the stomach.
Keep a routine eating and sleeping schedule. Regular but gentle exercise improves digestion and clears stagnation. Even a brief walk of 100 paces after eating helps get the digestive tract moving. Try changing the following lifestyle habits:
Avoid bending over or exercising soon after eating; avoid strenuous exercise
Avoid tight fitting belts and clothing that restrict movement of the abdomen.
Avoid working in front of a hot oven and general overexposure to sun and heat.
Acidity is high during digestion and during Pitta time of night (10pm to 2am). While sleeping, stomach acid regurgitates more easily because the esophagus is horizontal. The following techniques can help:
Eat your meals at least three hours before bed for the stomach to finish digestion.
Do not lie down after eating, even during the day.
Sleep with your body at an angle so that the head is raised about six inches above the feet. This can be accomplished by six inch blocks under the legs of the bed. Alternatively, purchase a wedge pillow.
The esophagus lies toward the left side of the body. Sleep on the right side to raise the esophagus and avoid acid back up.
There are many stress reduction techniques beyond the scope of this paper useful for acid reflux. A few highlights: Do not eat when emotional. Lions pose, shaking it out, dancing, meditation and breathing exercises can relieve pent up emotions. Twisting yoga poses can also help move emotions and can improve digestion but also push acids upwards. Use with caution.
Milky Oats (Avena sativa) reduces anxiety and worry. Elderberry (Sambucus canidensis) is grounding. Ashwagandha (Withania somnifera) brings calm and focus to a scattered mind. Massage relieves stress and tension.
Food should move downwards instead of stagnating or moving upwards. Materials that encourage food (and Vata) to move downwards (called an 'anuloma in Ayurveda) include warm water, carminatives such as cardamom, pungentaromatics such as fennel, and bitters such as neem or dandelion. Even though bitters stimulate Vata, they equally stimulate peristalsis.
Treatment of Subtypes
Kapha Acid Reflux
Treat Kapha Acid Reflux by clearing stomach stagnation, destroying mucus, improving metabolism and stimulating both digestion and bowel motility. Follow a Kapha pacifying diet avoiding wheat, red meat, ice-cream, cheese, refined sugars and fast food. Minimize overeating, emotional eating, and heavy foods after 5pm. Drink small sips of warm water spaced ten minutes apart to stimulate digestive function and bowel motility. Steamed bitters are soft enough for easy digestion and encourage peristaltic movement through the GI.
Treat gastritis by babying digestion, soothing the digestive tract lining, rebuilding the mucus layer, destroying parasites and clearing inflammation. Favor light, easy to digest foods that also reduce inflammation. Cool, demulcent foods like okra are ideal because they are mucilaginous and light. Avoid foods that irritate the digestive tract such as coffee and alcohol, or ones that provoke heat in the blood such as bell peppers or cigarettes. Favor cooling drinks like pomegranate, cranberry and aloe vera and herbs that clear heat such as amalaki and barberry (Berberis vulgaris). Demulcents, such as marshmallow (Althaea officinalis) and licorice root (Glycyrrhiza glabra), soothe inflammation. An anti-microbial, Goldenseal (Hydrastis canadensis), may be used in case of infection.
Treat hypoacidity by stimulating digestive secretions, rehydrating, and reducing the rate fermentation. Sips of warm water with a pinch of salt and a wedge of lime one hour before eating until the salivary glands and palate remain moistened replenish fluid loss from chronic dehydration. Take digestive stimulants such as fresh ginger and blood movers such as turmeric (Curcuma longa) to compensate for deficient blood or poor circulation. Detoxify with laxatives such as haritaki (Terminalia chebula). Reduce fermentation and proliferation of bacteria with anti-microbials such as vidanga (Embelia ribes). Demulcent foods (okra) and herbs (marshmallow root) will restore the mucus lining of the stomach. Favor nourishing anti-inflammatories such as shatavari (Asparagus racemosus) and licorice root.
Hydrating, building, and easy to digest foods such as soups with ghee, rice and carrots replenish and restore deficient fluids. Warm food with mild spices stimulate circulation and thus digestion. Stress management, especially during mealtimes, greatly improves circulation to the digestive tract. Avoid difficult to digest foods such as beans, peanuts, wheat, and egg yolks. Dried foods such as granola bars, toast, and diuretics like corn, can absorb too much fluid from the blood, increasing dehydration. A routine eating and sleeping schedule will precondition digestive organs for acid availability at mealtimes. Keep warm; a cold body temperature causes loss of fluids (cold diuresis).
The treatment paradigm for hyperacidity is to absorb excess acid and avoid stimulating the digestive tract by stress, intense emotions, or heating, spicy, or otherwise acid provoking foods. Heavy foods like barley and wheat absorb excess acids. Cooling and demulcent foods like bananas, avocado, cucumber and aloe vera soothe the mucus lining. Pomegranate and cranberry offer astringency to reduce inflammation and irritation. End meals with a small amount of sweet taste to soothe the gastric lining. Chilies, radishes and other spicy or pungent foods can over stimulate digestive juices. Ferments like pickles, wine and cheese also increase acid secretion. Sour taste generally increase digestive secretions and is usually indicative of acid in food. While acidity in tomatoes and spinach increase acid production in the stomach the citric acid in vinegar, lime and lemon actually reduce acid production. Limes are preferred because they are less Pitta provoking.
Fennel and fresh ginger share a dual advantage. They are both cooling digestives, a rare combination. Amalaki, like lime, is a cooling sour that also improves digestive function by stimulating micro-circulation and capillary bed level. Antacids such as sodium bicarbonate will help in acute cases but may fail to address the underlying cause. Lifestyle choices should address high stress and reduce emotional intensity in general.
Bile Deficiency and Obstruction
Treat bile problems by eating less fats, encouraging bile production, and in case of obstruction, diluting thick bile. Substances that increase the flow of bile and gallbladder contractions are called cholagogues. Sour taste from lemons increases production and thins bile for easy flow. Favor light foods with fewer fats such as soups with steamed or boiled greens and vegetables. Bitters stimulate bile production and contractions of the gallbladder. Some other prominent cholagogues include bhumyamalaki (Phyllanthus niruri) and dandelion root (Taraxacum officinale). Treatment of Pitta type bile obstruction/deficiency (jaundice) is beyond the scope of this paper.
Treatment with Western Medicine
Western medical doctors commonly attribute acid reflux to hyperacidity and do not normally test for hypoacidity. If you suspect hypoacidity ask your doctor to recommend testing. The following western medical tests are useful before selecting a pharmaceutical, herb, or treatment protocol:
DISCLAIMER: The pathogenesis of each person's condition is unique, and so the diet must be fit to the individual and the unique root causes of the condition in your body.
The information on this page is for educational purposes only and should not be used to treat a medical condition. It is not a substitute for medical care.
Please check with your doctor before making any changes to your health and wellness routine.
ACID REFLUX IS IN STAGE OF DISEASE #1 - AFFECTING DIGESTION
If you have symptoms in this category, your body is sending you a warning sign.
Since digestion is so metabolically intensive and sensitive to stress and emotions, the earliest warning signs of imbalance usually appear in the digestive tract first.
You may have gas and bloating, for example, or acid reflux.
Ayurveda recommends paying careful, close attention to warning signs.
They indicate that an imbalance is starting to accumulate.
Correct these warning signs before they accumulate further and weaken your body's resistance.
This is usually accomplished by removing diet and lifestyle habits that aggravate your imbalanced doshas and biocharacteristics.
AVOID DIETS, LIFESTYLES & HERBS THAT AGGRAVATE THESE EFFECTS
According to Ayurveda, one or more of the following
and biocharacteristics may aggravate 'Acid Reflux'.
If you have an excess of one of these doshas or biocharacteristics below, Ayurveda recommends reducing foods and lifestyle habits that aggravate them.
Click on the biocharacteristic to learn what foods and
lifestyle habits should be reduced.
Symptoms Tell A Story
The first step to healing is learning patterns from your symptoms.
Symptoms are clues that reveal underlying imbalances.
Symptoms show you where your body is weakened.
Ultimately, all disease has a root in tissues too weak to defend itself.
Ayurveda describes these patterns of weakness using doshas & biocharacteristics.
If you notice a biocharacteristic or dosha appears next to many of your symptoms,
it helps you establish a pattern that may be systemic.
Risk Factor: 40% less often Complication: +1.2 times as often
Please login or create a free account to see research statistics filtered on Acid Reflux and Intense emotions.
Biocharacteristics of 10,057 People Reporting Acid Reflux
On average the biocharacteristics
of people reporting Acid Reflux were more aggravated than 50% of other symptoms.
From the 10,057 people who reported Acid Reflux in this research study of 74,671 individuals,
average deviation in biocharacteristic levels were the following:
Please login or create a free account to see research statistics filtered on Acid Reflux and Cold.
8,107 have Cold constitution
Risk Factors of Acid Reflux
Below you will see general risk factors as well as the greatest risk factors, i.e. those who were also more likely to report Acid Reflux.
Overall, 25.96% of people surveyed in this research study reported Acid Reflux.
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HOW DOES AYURVEDA WORK?
Ayurveda starts by identifying your body type,
which identifies certain tendencies in your body to get sick (as well as identifying your strengths).
It uses body type to determine the likely root causes of your disorders.
Next, Ayurveda analyzes the nature of your disorder.
It fits all your signs and symptoms into a pattern, expressed as a combination of biocharaceristics (gunas).
For example, you may have a heat disorder, a cold disorder, or an oily disorder, etc.
This simple categorical approach shows you how to correct systemic imbalances and strengthen your body as a whole.
On Joyful Belly, we've created an extensive categorization of food so you can easily match food to your imbalanced biocharacteristics.
By eating an optimal diet that balances your biocharacteristics, your whole body is strengthened
and the conditions that created the disorder are removed. Once the root causes of the disease
are removed, the disease lessens in strength or disappears altogether. Additional remedies -
such as herbs and lifestyle practices - focused on the specific disorder, can greatly enhance
To get started on your Ayurvedic journey, we first recommend that your find your body
type by taking our free quiz. In Ayurveda, every solution is based on your unique body type, so
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John Immel, the founder of Joyful Belly, teaches people how to have a
healthy diet and lifestyle with Ayurveda biocharacteristics.
His approach to Ayurveda is clinical, yet exudes an ease which many find enjoyable and insightful.
John also directs Joyful Belly's School of Ayurveda,
offering professional clinical training in Ayurveda for over 15 years.
John's interest in Ayurveda and specialization in digestive tract pathology was inspired by a complex digestive disorder acquired from years of international travel,
as well as public service work in South Asia.
John's commitment to the detailed study of digestive disorders reflects his zeal to get down to the roots of the problem.
His hope and belief in the capacity of each & every client to improve their quality of life is nothing short of a personal passion.
John's creativity in the kitchen and delight in cooking for others comes from his family oriented upbringing.
In addition to his certification in Ayurveda, John holds a bachelor's degree in mathematics from Harvard University.
John enjoys sharing Ayurveda within the context of his Catholic roots,
and finds Ayurveda gives him an opportunity to participate in the healing mission of the Church.
Jesus expressed God's love by feeding and healing the sick.
That kindness is the fundamental ministry of Ayurveda as well.
Outside of work, John enjoys spending time with his wife and 6 kids, and pursuing his love of theology, philosophy, and language.